青光眼患者手术后感染性眼内炎的临床分析  

Clinical analysis of postoperative infective endophthalmitis in glaucoma patients

作　　者：姚慧卿 龚昌裕 韩鑫栋 

机构地区：[1]绍兴市上虞区第二人民医院眼科,浙江绍兴312365

出　　处：《中华医院感染学杂志》2014年第22期5642-5644,共3页Chinese Journal of Nosocomiology

基　　金：国家卫生部规划基金资助项目(GW-2009B-028)

摘　　要：目的分析青光眼患者复合式小梁切除术后感染性眼内炎的临床危因素,并提出相应的防治对策,减少其发生。方法选取2001年3月-2013年5月行复合式小梁切除术的青光眼患者1 233例,对其临床资料进行回顾分析,对不同性别、年龄、青光眼类型、合并疾病以及治疗方案患者发生眼内炎的概率进行统计,并行logistic回归分析。结果 1 233例患者共发生眼内炎14例,发生率为1.14%;高龄、合并睑内翻倒睫、合并糖尿病、夏季、非层流手术室手术、未进行健康教育、未限制病房探视的患者发生眼内炎概率明显高于不存在上述因素的患者(P<0.05);经多因素回归分析上述高危因素均为青光眼复合式小梁切除术感染性眼内炎的独立危险因素(P<0.05)。结论青光眼复合式小梁切除术后感染性眼内炎的危险因素多样,应给予针对性的预防,一旦发生感染性眼内炎,应立即给予万古霉素联合玻璃体切割手术进行治疗。OBJECTIVE To explore the risk factors for infective endophthalmitis in the glaucoma patients after the compound trabeculectomy and put forward corresponding prevention countermeasures so as to reduce the incidence of infective endophthalmitis .METHODS A total of 1 233 glaucoma patients who underwent the compound trabecu‐lectomy from Mar 2001 to May 2013 were enrolled in the study ,then the clinical data of the patients were retro‐spectively analyzed ,the incidence rate of infective endophthalmitis in the patients with different genders ,age , types of glaucoma ,complications ,and treatment programs were statistically analyzed ,and the logistic regression analysis was performed .RESULTS The endophthalmitis occurred in 14 of 1 233 patients with the incidence rate of 1 .14% ;the incidence rate of endophthalmitis was significantly higher in the patients with advanced age ,complica‐tion of entropion trichiasis ,complication of diabetic mellitus ,summer ,non‐laminar flow operating room ,without health education ,and unrestricted ward visiting than in the patients without the above factors （P〈0 .05）;the multivariate regression analysis showed that all of the above high risk factors were the independent risk factors for the infective endophthalmitis in the glaucoma patients undergoing the compound trabeculectomy （ P〈 0 .05 ） . CONCLUSION The risk factors for the postoperative infective endophthalmitis in the patients undergoing the com‐pound trabeculectomy are diversified .It is necessary to conduct targeted prevention and carry out the vancomycin combined with vitrectomy in a timely manner once the infective endophthalmitis occurs .

关 键 词：青光眼 小梁切除术 感染 眼内炎 危险因素 

分 类 号：R619.3[医药卫生—外科学]